Insulin Resistance and Cardiometabolic Risk Factors in Latino Young Adults without Diabetes in Puerto Rico

Introduction and Objective: Insulin resistance (IR) is associated with cardiometabolic risk factors (CMRFs), yet its role among young Latino adults without diabetes is underexplored. This study examined these associations in young adults in Puerto Rico, a population with a high diabetes risk. Methods: Data from 2,493 participants (18-29 y, 62% female) in the PR-OUTLOOK study without diabetes (defined as a history of diagnosed diabetes, use of diabetes medication, FBS ≥126 mg/dL, or HbA1c ≥6.5%) were analyzed. IR, assessed using the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR≥2.5), and CMRFs, including hypertension (≥130/≥80 mmHg), elevated LDL-C (≥100 mg/dL), high triglycerides (≥150 mg/dL), and prediabetes (FBS: 100-125 mg/dL or HbA1c: 5.7%-6.4%), reduced HDL-C (<40 mg/dL in men, <50 mg/dL in women), and number of CMRFs (0=reference, 1, 2, ≥3) were evaluated. Binary and multinomial logistic regression assessed associations between IR and individual CMRFs and the number of CMRFs, respectively, adjusted for age, marital status, maternal education, subjective social status, diet, health insurance, smoking, physical activity, and BMI. Results: IR was present in 41.7% of all participants. Adjusted analyses showed significant associations between IR and high triglycerides (OR=3.48, 95%CI=2.45-4.93), prediabetes (OR=3.27; 95%CI=2.56-4.19), reduced HDL-C (OR=1.92; 95% CI=1.60-2.30), and hypertension (OR=1.34, 95% CI=1.05,1.71). IR was also associated with an increasing number of CMRFs (1 CMRF: OR=1.39; IC 95%=1.12-1.72; 2 CMRFs: OR=2.31, 95% CI=1.78-2.99; 3 CMRFs: OR=5.15, 95% CI=3.54-7.48). Conclusion: IR is associated with multiple CMRFs among young adults without diabetes, highlighting its potential as a target for intervention to reduce cardiometabolic risk. Disclosure: C.M. Perez: None. I.A. Almodovar-Rivera: None. L. Gonzalez-Rodriguez: Research Support; Eli Lilly and Company, Merck Sharp & Dohme Corp. C. Kiefe: None. J.F. Rodriguez: None. M.C. Rosal: None. Funding: National Institutes of Health (R01HL149119)